Antigenemia y reacción de polimerasa en cadena en tiempo real en el diagnóstico de enfermedad por citomegalovirus en adultos con virus de inmunodeficiencia adquirida

Luchsinger, Vivían; Vásquez, Patricia; Silva, Matias; Bruno, Minerva; Siches, Izkia; Villarroel, J. Paul Perales; Garmendia, María Luisa; Larrañaga, Carmen

doi:10.4067/s0716-10182015000700008

Cited by 4 publications

(5 citation statements)

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“…In this work, a comparison between CMV diseased patients and those only infected was carried out including patients admitted with symptoms and/or laboratory abnormalities suggestive of CMV compromise. We did not include asymptomatic outpatients as in other Chilean studies 6 . Our approach allows a better estimation of a numerical value able to separate those diseased from those infected because a real clinical scenario was considered.…”

Section: Discussionmentioning

confidence: 99%

“…Cytomegalovirus (CMV) is an aIds-defining illness affecting different organs (for example retinitis or colitis) or by a febrile disease associated with hematological alterations with or without increased serum transaminases denominated CMV disease. These complications arise by viral reactivation secondary to advanced immunosuppression, however, asymptomatic transient reactivation events also can occur, which turned to be evident when quantitative techniques in blood or plasma samples are incorporated [4][5][6] . distinction between disease and reactivation is necessary in every suspicious case to avoid overtreatment for CMV in a patient who has another cause for the symptoms.…”

mentioning

confidence: 99%

“…some publications on immunosuppressed patients affected by CMV in Chile have evaluated viral loads in a quantitative manner to identify patients with CMV illness 7,8 . although a comparison between CMV diseased versus asymptomatic patients 6 , no clear cut-off points to distinguish infection from disease in routine clinical settings are available for aIds patients in our country. Besides, a more detailed clinical information on the symptoms associated with CMV in aIds patients, their response to therapy, viral clearance and outcome is desirable.…”

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confidence: 99%

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Cytomegalovirus infection in AIDS patients. An illustrative case series

et al. 2020

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Background: Cytomegalovirus (CMV) is an opportunistic infection (OI) in immunosuppressed patients. However, there are no clear cutoff values available for quantitative plasmatic CMV measures (viral load [VL]) to discriminate those with CMV illness from those infected suffering a transient viral reactivation. Aim: To estimate a CMV VL cutoff point that discriminates infected patients and those with CMV related diseases, and to clinically characterize AIDS patients with this OI. Patients and Methods: Retrospective analysis of AIDS patients admitted by any reason between years 2017 and 2019 and who had a positive plasma CMV VL at any titer. Cases were categorized with illness or infected using accepted criteria and the cutoff value was obtained by receiver operating characteristic curve (ROC) analysis. Results: Twelve patients were identified as having a CMV-associated illness and seven with CMV infection. A CMV VL of 3,800 copies/mL had a sensitivity of 91.6% and 100% specificity to discriminate both states. Of the 12 patients with CMV illness, all were in AIDS stage and only five were receiving HIV therapy. Predominant clinical presentations were gastrointestinal (50%), followed by liver involvement (25%) and CMV disease (25%). All patients were treated with ganciclovir or valganciclovir. Ten patients had a favorable response (83.3%), one patient only had a laboratory improvement (8.3%) and one died during treatment (8.3%). Drug toxicity was recorded in nine patients but in only three cases, a dose adjustment was necessary. Conclusions: The predominant clinical manifestation in our series was gastrointestinal. A CMV VL cutoff level of CMV VL of 3,800 copies / mL is useful to discriminate infected patients from those with CMV related disease.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Cytomegalovirus infection in AIDS patients. An illustrative case series

et al. 2020

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“…En pacientes que no tienen infección por CMV, se ha visto una recuperación más rápida con la HAART(4), en tanto que la persistencia de dicha infección se ha asociado con mayores cargas virales de HIV (5)(6). En los pacientes infectados con HIV y CMV, también se ha observado un mayor riesgo de condiciones clínicas no relacionadas con el sida (aterosclerosis y afecciones cardiovasculares) (7).…”

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Wernicke-Korsakoff syndrome secondary to cytomegalovirus encephalitis: A case report

et al. 2017

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: descripción del caso clínico y del marco teórico sustentado durante la discusión Camilo Lara y Natalia Rueda: resumen de presentación del artículo, descripción de los aspectos radiológicos del caso clínico, sustentación de los hallazgos en imágenes descritos en casos previamente publicados Todos los autores contribuyeron a la discusión y la edición del manuscrito. El citomegalovirus (CMV) es uno de los microorganismos oportunistas con mayor prevalencia en pacientes inmunocomprometidos, aunque su reactivación ha descendido después de la introducción de la terapia antirretroviral altamente activa (Highly Active Antiretroviral Therapy, HAART). En las coinfecciones, la encefalitis se ha reportado como una de las condiciones más frecuentes. Se presenta el caso de un paciente adulto joven con infección por virus de la inmunodeficiencia humana (HIV) que tuvo un rápido deterioro neurológico evidenciado en síntomas y signos clínicos clásicos del síndrome de Wernicke-Korsakoff y que no presentaba factores de riesgo para deficiencia de tiamina. En las imágenes de la resonancia magnética cerebral, se detectaron hallazgos típicos del síndrome, y se identificó citomegalovirus (CMV) en el líquido cefalorraquídeo. Con el tratamiento específico para el CMV, se logró el control de los síntomas, aunque hubo secuelas neurológicas que mejoraron. Este es uno de los pocos casos reportados a nivel mundial de síndrome de Wernicke secundario a encefalitis por citomegalovirus. Wernicke-Korsakoff syndrome secondary to cytomegalovirus encephalitis: A case reportCytomegalovirus (CMV) is one of the opportunistic microorganisms with the highest prevalence in immunocompromised patients. Reactivation has decreased after the introduction of highly active antiretroviral therapy (HAART). Encephalitis has been reported in the coinfection as one of the most frequent presentations. We present the case of a young adult patient with HIV infection and rapid neurological deterioration due to classic clinical symptoms and signs of the Wernicke-Korsakoff syndrome, with no risk factors for thiamine deficiency, with images by nuclear magnetic resonance typical of the syndrome, and identification of cytomegalovirus in cerebrospinal fluid. The specific treatment for CMV managed to control the symptoms with neurological sequelae in progression towards improvement. This is one of the few cases reported in the literature of Wernicke syndrome secondary to cytomegalovirus encephalitis. La infección por el virus de la inmunodeficiencia humana (HIV) continúa siendo una de las de mayor trascendencia en el mundo; los informes epidemiológicos internacionales indican que, si bien la incidencia ha disminuido de 2,2 millones de personas infectadas en el 2010 a 2,1 millones en el 2015, la prevalencia ha aumentado de 33,3 millones a 36,7 millones en el mismo periodo. Por otra parte, las muertes relacionadas con el sida se han reducido de 1,5 millones en el 2010 a 1,1 millones en el 2015 (26 %) (1). Ello significa que las tasas de transmisión han disminuido y que la expecta...

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“…Apesar desse uso questionável, há estudos que sugerem um cut-off para qPCR-CMV realizadas em amostras de sangue ou plasma a partir do qual poderia estar presente a doença invasiva pelo CMV, com valores de corte para tratamento e de acuracia do exame variando bastante entre os estudos (BRANTSAETER et al, 2007;LUCHSINGER et al, 2015;MIZUSHIMA et al, 2015;YOSHIDA et al, 2001).…”

Section: Diagnóstico De CMV Em Pacientes Hiv/aidsunclassified

O papel da PCR quantitativa para citomegalovírus no diagnóstico e manejo de pessoas vivendo com HIV/AIDS no Hospital de Clínicas de Ribeirão Preto

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Antigenemia y reacción de polimerasa en cadena en tiempo real en el diagnóstico de enfermedad por citomegalovirus en adultos con virus de inmunodeficiencia adquirida

Cited by 4 publications

References 23 publications

Cytomegalovirus infection in AIDS patients. An illustrative case series

Cytomegalovirus infection in AIDS patients. An illustrative case series

Wernicke-Korsakoff syndrome secondary to cytomegalovirus encephalitis: A case report

O papel da PCR quantitativa para citomegalovírus no diagnóstico e manejo de pessoas vivendo com HIV/AIDS no Hospital de Clínicas de Ribeirão Preto

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